title: Postinfective bile acid malabsorption: is this a long-term condition?
abstract: BACKGROUND
  Postinfective bile acid malabsorption comprises a group of patients with a history of an episode of acute gastroenteritis triggering chronic diarrhoea. We identified these patients retrospectively from our medical records and assessed their long-term clinical course.
  
  
  METHODS
  We examined the records of 135 patients with 75 selenium-homocholic acid taurine results less than 10% (1 week retention).
  
  
  RESULTS
  Twenty-five patients (13 female, 12 male) had a diagnosis of postinfective bile acid malabsorption established after extensive investigations. Cholestyramine was used to treat diarrhoea with a mean frequency of diarrhoea decreasing from 7.8 to 1.9 (P=0.001). The mean cholestyramine dose decreased from 8.2 to 5.4 g/day (P=0.005). Eighteen of 25 (72%) patients had a successful resolution of their diarrhoea by cholestyramine and have continued it to date. The median duration of outpatient follow-up was 1.58 years (range: 1-5 years). A further prospective telephone enquiry of these 18 patients revealed that 15 of 18 patients continued to take cholestyramine (median: 6 years, range: 1-15 years). There were no hospital admissions related to diarrhoea and there was no mortality in this group of patients.
  
  
  CONCLUSIONS
  The long-term outlook of this group of patients is excellent. We have shown the chronic nature of this condition as evidenced by the continued requirement of cholestyramine.
authors.affiliation: Department of Gastroenterology, Sandwell General Hospital, West Bromwich, UK. dr.s.menon@gmail.com
authors.forename: Shyam
authors.initials: S
authors.lastname: Menon
authors.forename: Barry J M
authors.initials: BJ
authors.lastname: Jones
mesh_terms: D000208:Acute Disease; D000837:Anion Exchange Resins / Q000627:therapeutic use; D001647:Bile Acids and Salts / Q000378:metabolism*; D002169:Campylobacter Infections / Q000188:drug therapy / Q000378:metabolism* / Q000382:microbiology; D002792:Cholestyramine Resin / Q000627:therapeutic use; D003967:Diarrhea / Q000188:drug therapy / Q000378:metabolism* / Q000382:microbiology; D004405:Dysentery, Bacillary / Q000188:drug therapy / Q000378:metabolism* / Q000382:microbiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008286:Malabsorption Syndromes / Q000188:drug therapy / Q000378:metabolism* / Q000382:microbiology; D008297:Male; D011446:Prospective Studies; D012189:Retrospective Studies; D012764:Shigella sonnei / Q000302:isolation & purification*; D016896:Treatment Outcome
chemical_list: D000837:Anion Exchange Resins; D001647:Bile Acids and Salts; D002792:Cholestyramine Resin